Hypoparathyroidism remains one of the few endocrine deficiency syndromes where the missing hormone is not the standard first-line replacement, creating unique clinical and care challenges. This presentation will feature a series of clinical cases of hypoparathyroidism and discuss short- and long-term complications of hypoparathyroidism along with the traditional treatment options of high-dose oral calcium and active vitamin D. Newer therapeutic options including parathyroid hormone replacement therapy will be discussed. Beyond biochemical targets, the presentation highlights the endocrine nurse’s pivotal role in education, preventing acute complications like tetany, and mitigating long-term risks such as renal damage.